Presence Of Chlamydia Trachomatis Research Articles

Frequency of Chlamydia trachomatis and Neisseria gonorrhoeae in Patients with Imminent Preterm Delivery on the Island of Curaçao.

Sexually transmitted infections are one of the important risk factors for preterm delivery, which is among the important contributors to perinatal morbidity and mortality. The aim of this study was to assess the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in women with imminent preterm delivery in Curaçao, an island of the Dutch Caribbean. All women from Curaçao with either preterm premature rupture of the membranes or preterm labor, common indications of imminent preterm delivery, and presenting at the Curaçao Medical Center between 15 November 2019 and 31 December 2020, were included in this single cohort study. Data were retrospectively collected from medical records. The presence of Chlamydia trachomatis and Neisseria gonorrhoeae was assessed by Cepheid GeneXpert ® (Xpert) CT/NG assay (Sunnyvale, CA, USA). In the included cohort, the prevalence of Chlamydia trachomatis infection was 15.5% and of Neisseria gonorrhoeae infection was 2.1%. All patients infected with Neisseria gonorrhoeae were co-infected with Chlamydia trachomatis. The prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in patients with imminent preterm delivery in Curaçao is high. It is recommended to test all patients with imminent preterm delivery for these sexually transmitted infections and possibly consider testing all women in early pregnancy on the island.

Immunohistochemical detection of chlamydia trachomatis in sexually transmitted infectious proctitis

IntroductionSince 2003, a progressive increase in sexually transmitted infections (STI), presented as proctitis, has been described in homosexual men. In 2013 Arnold et al. described microscopic features that enable pathologists to formulate a histological diagnosis of STI related proctitis. The aim of this study is to identify the presence of Chlamydia trachomatis by immunohistochemistry in a group of patients with male to male sexual activity and pathology compatible with STI proctitis.MethodsCross-sectional study. The study included 54 patients with risky sexual activity and histopathology compatible with STI-proctitis according to Arnold´s recommendations. The Chlamydia trachomatis identification was carried out retrospectively on paraffin blocks using mouse monoclonal antibodies from Santa Cruz biotechnology.Resultsall patients were young men with male to male sexual activity, 69% were positive for HIV. The most common endoscopic presentation was rectal ulcer (61%). Basal lymphoplasmacytic inflammation and mild crypt distortion were the most common histological findings. The immunohistochemical study identified positivity for Chlamydia trachomatis in 40% (18 of 45 tested) of STI proctitis cases.DiscussionThe epidemiological and endoscopic characteristics of the patients studied are similar to those previously reported. In accordance with Arnold et al., the most common histological findings were (a) mild distortion of the crypts; (b) dense and basal lymphoplasmacytic infiltrate and (c) scarcity of eosinophils. The positivity of chlamydia trachomatis in immunohistochemistry was lower than others studies that used PCR for this purpose. We did not find similar published studies to compare our results.ConclusionsIn summary, 54 cases of patients with STI related proctitis are presented, all of them with distinctive histological characteristics and third of the cases tested positive by IHC for Chlamydia trachomatis.

Copan Walk Away Specimen Processor (WASP) Automated System for Pathogen Detection in Female Reproductive Tract Specimens

ObjectiveAutomation is increasingly being applied in clinical laboratories; however, preanalytical processing for microbiology tests and screening is still largely performed using manual methods owing to the complex procedures involved. To promote automation of clinical microbiology laboratories, it is important to assess the performance of automated systems for different specimen types separately. Therefore, the aim of this study was to explore the potential clinical application of the Copan Walk Away Specimen Processor (WASP) automated preanalytical microbiology processing system in the detection of pathogens in female reproductive tract specimens and its feasibility in optimizing diagnostic procedures.MethodsFemale reproductive tract specimens collected from pregnant women at their first obstetric check-up were inoculated into culture media using the Copan WASP automated specimen processing system and were also cultured using a conventional manual inoculation method. After 48 h of culture, the growth of colonies was observed, and the types of bacteria, number of colonies, and efficiency in isolating single colonies were compared between the automated and manual groups. The specimens collected from the WASP system using the Copan-ESwab sample collection tubes were further analyzed for the presence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Ureaplasmaurealyticum (UU) via fluorescence quantitative polymerase chain reaction (qPCR) and an immunochromatographic assay to investigate the feasibility of this method in optimizing detection of these common pathogens of the female reproductive tract.ResultsCompared with the manual culture method, the Copan WASP microbiology automation system detected fewer bacterial types (P<0.001) and bacterial colonies (P<0.001) but had a higher detection rate of single colonies (P<0.001). There was no significant difference in the detection rates of common pathogens encountered in clinical obstetrics and gynecology, including group B Streptococcus (GBS) (P=0.575) and Candida (P=0.917), between the two methods. Specimens collected in the Copan-ESwab tubes could be used for screening of GBS and CT via fluorescence-based qPCR but not with immunochromatography. However, UU and NG were not detected in any sample with either method; thus, further validation is required to determine the feasibility of the Copan system for screening these pathogens.ConclusionThe Copan WASP microbiology automation system could facilitate the optimization of diagnostic procedures for detecting common pathogens of the female reproductive system, thereby reducing associated costs.

English

BACKGROUND Pelvic inflammatory disease is a spectrum of diseases affecting the female upper genital tract. It is a poly microbial infection and Chlamydia trachomatis is the most common causative agent. We have undertaken this study with the objective of determining the prevalence of Chlamydia trachomatis infection in pelvic inflammatory disease (PID). METHODS This cross-sectional study consisted of 100 non-pregnant women with clinical features of PID. Endocervical, vaginal swabs and blood samples were collected from them. Polymerase-chain-reaction test (PCR) and enzyme-linked immunosorbent assay (ELISA) for chlamydial detection and Gram’s staining &amp; culture for other pathogens were performed. Chi-square and Fisher’s exact tests were used to study association between the clinical features and Chlamydia trachomatis positivity. RESULTS The prevalence rate of chlamydia was 15.1 %. The other organisms isolated were candida species in 12.9 % and Escherichia coli in 5.3 % of the study population. There was no association between the various demographic variables, menstrual problems, fever, urinary symptoms, history of infertility, abortions, instrumentations and the presence of Chlamydia trachomatis. A significant association was found between the lower abdominal pain which increased during menstruation (P = 0.013) and the two clinical signs, cervical motion tenderness and uterine tenderness (P = 0.001) with the presence of Chlamydia trachomatis and other cervical infections. CONCLUSIONS The prevalence rate of Chlamydia trachomatis in pelvic inflammatory disease was 15 % and other organisms isolated from the cervical swabs were candida species and Escherichia coli. KEY WORDS Pelvic Inflammatory Diseases, Chlamydia trachomatis

Preliminary Results of a Screening Programme for Chlamydia in an Asymptomatic Young Population in Spain.

Introduction: Chlamydia trachomatis (CT) infection has increased in recent years, reaching 127 million cases in 2016. Possible complications, especially among women, require intervention for early detection of the infection. The objective of our study was to determine the prevalence of CT infection in a young, sexually active, asymptomatic population.Methods: A cross-sectional study was conducted between December 2017 and 31 December 2018 among young patients aged 18–25 years attending the emergency room for any reason. The presence of CT and other STIs in urine was determined by the Allplex Nucleic Acid Amplification Test (NAAT) with a urine sample. All patients testing positive were followed by the STD unit and tests on all sexual partners/contacts were offered. Moreover, we obtained data about sexual habits and risk factors via a self-reporting questionnaire.Results: One thousand three hundred eight patients were eligible for inclusion of whom 298 consented to participate. Of these, 22/298 (7.4%) were diagnosed with CT. Young people with two or more sexual partners in the last month and those suffering from infection by ureaplasma were at greater risk of infection by CT. Up to 50% of participants do not use barrier methods.Conclusion: The prevalence of infection by CT in the asymptomatic young population is higher than expected according to the recent literature in Spain. The scarce use of barrier methods among this population may be one of the causes of this increase and one of the targets to work on in order to reduce the prevalence of the infection.

Flies as possible vectors of inflammatory trachoma transmission in a Brazilian municipality.

ABSTRACTTrachoma is a keratoconjunctivitis caused by Chlamydia trachomatis, considered an important leading cause of preventable blindness in the world. This study aimed at verifying if flies can be the vectors for trachoma in our municipality. Flies were assessed in the households of children diagnosed with inflammatory trachoma at the municipality of Botucatu, Sao Paulo State, Brazil. Fly traps were placed in the backyard of the houses during 24 h, in each of the four weather seasons, over a period of one year. The collected dipterans were taxonomically classified and the presence of Chlamydia trachomatis in the flies was evidenced by using the Polymerase Chain Reaction (PCR). During the studied period, 2,188 flies were collected, mainly during the summer and the spring. The most common identified fly was Musca domestica. All fly samples were negative for Chlamydia trachomatis but several other different bacteria were identified in these flies. The authors concluded that flies are probably not the vectors for trachoma in the studied area. Further studies should be conducted to evaluate other possible factors responsible for the maintenance of the disease in our environment.

LEVEL OF SEX HORMONES AND THE SEVERITY OF HYPERPLASTIC PROCESSES IN THE GENITAL TRACT IN WOMEN WITH CHRONIC CHLAMYDIAL INFECTION

Purpose of the study. To evaluate the role of chronic chlamydial infection in the genesis of proliferative processes in the female genital area.Materials and methods. The study involved 267 women aged from 27 to 43 years. Depending on the severity of the pathological process in the genital tract and the presence of the Chlamydia trachomatis infection, 6 groups were distinguished: 1st — 30 somatically healthy women without pathologies of the female reproductive system; 2nd and 3rd — those with inflammatory processes in the reproductive organs of non-chlamydial (36) and chlamydial nature (38); 4th and 5th — those with proliferative processes in the pelvic organs of non-chlamydial (50) and chlamydial nature (58); 6th — patients with cervical cancer (55). The PCR and ELISA (Chem Well, USA) methods were used to identify the presence of Chlamydia trachomatis. The concentration of estradiol (E) and progesterone (P) (ELISA) in the blood, as well as their ratio (E/P), was determined. The as-obtained data were compared with the results of cytomorphological and ultrasound studies.Results. Proliferative processes in the genital tract are accompanied by a change in the level of female sex hormones, in particular, by a sharp decrease in progesterone in the luteal phase of the cycle against the background of absolute or relative hyperestrogenism. These changes are more pronounced in women with chronic chlamydial infection. A connection between the presence of the infectious agent in question and the severity of hyperplastic processes in the female genital tract is established. A comparison of the obtained morphological data with the blood progesterone content in women without Chlamydia trachomatis showed that an increase in the severity of disorders correlates with a decrease in the level of female hormones. In women infected with Chlamydia trachomatis, the severity of hyperplastic processes shifts to the right, i. e. towards normal progesterone values. Therefore, even at maximal progesterone concentrations close to the reference values, a greater severity of pathological changes is observed.Conclusion. The obtained results demonstrate the undeniable role of chronic chlamydial infection in initiating a hormonal imbalance towards absolute or relative hyperestrogenia with a severe progesterone deficiency. A causal relationship of the Chlamydia trachomatis infectious agent with the severity of hyperplastic processes in the pelvic organs is established. It is concluded that the detection of chlamydial infection should be considered as an essential element in the screening and prevention of hyperplastic processes.

FEATURES OF SYSTEM IMMUNITY IN WOMEN WITH ENDOMETRIOSIS AND GENITAL INFECTION

External genital endometriosis is an inflammatory, estrogen-dependent disease that develops predominantly in women of reproductive age and is characterized by the presence of pain syndrome and infertility. Today, endometriosis is one of the most common gynecological diseases in women of reproductive age, however, the etiology and pathogenesis of it are not completely clear. Violations of systemic immunity are most important in the pathogenesis of endometriosis. The literature data on the features of the immune response in endometriosis in combination with genital infection are few and contradictory. Purpose – to study the features of systemic immunity in women with external genital endometriosis and pathogens of genital infection.A total of 159 women with external genital endometriosis were examined. The main lymphocyte subpopulations, the functional activity of neutrophils and peripheral blood monocytes, and the content of cytokines in the blood serum were studied. A study of systemic immunity was performed in women with 1-2 and 3-4 stages of endometriosis, as well as depending on the presence of pathogens of genital infection. The presence of Chlamydia trachomatis, Ureaplasma spp., Mycoplasma genitalium, HSV1, 2/CMV, HPV in the endometrium, peritoneal fluid, and endometrioid heterotopies was determined. Statistical processing was performed using the IBM SPSS Statistics Version 22.2 statistical analysis software package.According to the results of the study, it was found that women with endometriosis of stages 1-2 show signs of systemic inflammation with a predominance of the Th2 type of immune response and inhibition of cellular immunity. A particular feature of HPV was an increase in T-NK lymphocytes, a decrease in IL-2 and neutrophil functional activity. The presence of Ureaplasma spp./Mycoplasma genitalium was characterized by a decrease in cellular immunity and an increase in T-NK cells. Only with HPV and Ureaplasma spp./Mycoplasma genitalium decreased synthesis of IL-2, IL-6. With 3-4 stages, the most significant changes in immunity were found in groups of women with genital infection. When HPV – a high level of IgA, increased IgM, IL-8. With Ureaplasma spp./Mycoplasma genitalium – inhibition of cellular immunity, high levels of IgA, reduction of neutrophil phagocytic activity.Thus, in women with endometriosis in the presence of pathogens of genital infection revealed features that may contribute to the development and progression of the disease.

Acute pelvic inflammatory disease: a narrative review

Background and objective: Pelvic inflammatory disease (PID) is an upper genital tract infection in females that is typically acquired via sexual activity. It usually is initiated by the presence of Chlamydia trachomatis and/or Neisseria gonorrhoeae and escalates into a polymicrobial infection from local genital tract flora. Research identifies various known risk factors including young age, immunopathology and others. This article reviews the epidemiology, differential diagnosis, management, and concepts of prevention for PID. Methods: An electronic search was performed on MEDLINE to identify relevant articles from 2010 to 2018. Key Content and Findings: PID continues to be a major sexually transmitted disease among adolescent and young adult females. Among the 1 million cases that are found in the United States (U.S.) each year, about one-third are in adolescent females. It is typically a polymicrobial infection that can lead to acute salpingitis, perihepatitis, endometritis, oophoritis, pelvic peritonitis and/or tubo-ovarian abscess. Diagnostic criteria and recommended treatment have been developed by the U.S. Centers for Disease Control and Prevention (CDC). Complication of PID include chronic pelvic pain, ectopic pregnancy and infertility. Conclusions: PID is a common sexually transmitted disease that is found in many adolescents and young women. The possibility of PID should be seriously considered by clinicians when evaluating a sexually active teenage or young adult female with lower abdominal pain, vaginal discharge, vaginal bleeding, urinary symptoms, post-coital bleeding and/or dyspareunia. It may be a silent infection as well. Various risk factors for PID are noted including the adolescent age group, ectropion of young adolescent females, immature immune system, multiple coital partners and others. Clinicians should follow treatment protocols established by the CDC and the World Health Organization (WHO). The problem of PID should stimulate clinicians and society to provide comprehensive sexuality education to our youth.

Sexually transmitted agents and their association with leucocytospermia in infertility clinic patients.

In this study, the presence of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum and Ureaplasma parvumDNA were investigated using real-time multiplex PCR detection kit in the urine samples of 50 patients who presented to the infertility polyclinic. Patients were classified into two groups in accordance with the WHO leucocytospermia criteria as over 1×106 /ml (n=25) and below 1×106 /ml (controls; n=25). In addition, the semen sample results of the patients were evaluated. The mean leucocyte count in the leucocytospermia group was detected as 3.4×106 /ml. Agent positivity was found in 12 of 25 patients in the leucocytospermia group (U.parvum 10, U.urealyticum 3, M.hominis 3) and 9 of 25 patients in the control group (U.parvum 7, U.urealyticum 2, M.hominis 1). A chi-square test evaluation revealed no statistically significant difference between groups. (p=0.390). The statistical evaluation using the Mann-Whitney U and chi-square tests revealed no statistically significant negative effect of agent positivity on semen analysis parameters in either group (p>0.05). Although no significant difference was detected between the groups, this study provides data about the prevalence of asymptomatic sexually transmitted diseases in patients presenting to the infertility polyclinic.

PCR diagnostics of Chlamydia trachomatis in asymptomatic infection by women.

Chlamydial infection is often asymptomatic. The lack of symptoms may result in the infection developing into a chronic. Chlamydial infections of the genitourinary system in women can lead to serious complications like PID, fallopian tubes infertility, ectopic pregnancy, and chronic pelvic pain. An infection of the genitourinary system does not cause any lasting immune resistance and does not protect against re-infection. The aim of this research was to conduct tests for Chlamydia trachomatis on healthy women without any genital system symptoms and to estimate the frequency of asymptomatic infections. During preventive examinations a cervical smear was obtained from the patients n = 100. The aver-age age of the patients was 24.86 ± 3.15. The swabs were sampled by gynecologists. During the examinations Geneproof PathogenFree DNA isolation Kit and GeneProof Chlamydia trachomatis PCR kit which detects 16S rRNA conservative coding sequence, conservative region of cryptic plasmid DNA, including deletion mutation in cryptic plasmid (Swedish variant). Swabs were sampled from 100 women aged 18-32 who had no symptoms of chlamydial genitourinary system infection. Within the study group 4% of women received a positive result, i.e. 4/100. The study confirmed asymptotic infection in 4% of women. In own research it was not possible to confirm cor-relation between the presence of Chlamydia trachomatis and the number of partners or the number of sexual intercourses.

Presence of Chlamydia trachomatis and Mycoplasma spp., but not Neisseria gonorrhoeae and Treponema pallidum, in women undergoing an infertility evaluation: high prevalence of tetracycline resistance gene tet(M)

Chlamydia trachomatis, Mycoplasma spp., Neisseria gonorrhoeae and Treponema pallidum are sexually transmitted pathogens that threaten reproductive health worldwide. In this study, vaginal swabs obtained from women (n = 133) that attended an infertility clinic in China were tested with qPCRs for C. trachomatis, Mycoplasma spp., N. gonorrhoeae, T. pallidum and tetracycline resistance genes. While none of vaginal swabs were positive for N. gonorrhoeae and T. pallidum, 18.8% (25/133) of the swabs were positive for Chlamydia spp. and 17.3% of the swabs (23/133) were positive for Mycoplasma species. All swabs tested were positive for tetracycline resistance gene tet(M) which is the most effective antibiotic for bacterial sexually transmitted infections. The qPCRs determined that the gene copy number per swab for tet(M) was 7.6 times as high as that of C. trachomatis 23S rRNA, and 14.7 times of Mycoplasma spp. 16S rRNA. In China, most hospitals do not detect C. trachomatis and Mycoplasma spp. in women with sexually transmitted infections and fertility problems. This study strongly suggests that C. trachomatis and Mycoplasma spp. should be routinely tested in women with sexually transmitted infections and infertility in China, and that antimicrobial resistance of these organisms should be monitored. Further studies are warranted to determine the prevalences in different regions and associated risk factors.

Higher prevalence of colonization with Gardnerella vaginalis and gram-negative anaerobes in patients with recurrent miscarriage and elevated peripheral natural killer cells

The role of vaginal infections in recurrent miscarriage (RM) is discussed controversially and screening is not recommended in international guidelines. Peripheral and uterine NK cells (pNK, uNK) play an important role in the establishment of a healthy pregnancy and are targets of immune diagnostics in RM patients. The aim of this study was to analyze the composition of the vaginal microbiota in RM patients and to correlate the findings to clinical characteristics as well as NK cell parameters. In total, n=243 RM patients with ≥3 consecutive miscarriages were recruited between 11/2011 and 03/2016. Vaginal swabs were analyzed by microbiological culture. Further, a cervical swab was taken in n=187 patients and the presence of Chlamydia trachomatis was evaluated by a molecular assay. Peripheral blood levels of CD45+CD3−CD56+CD16+ pNK (determined by four-color fluorescence flow cytometry) and CD56+ uNK (uterine biopsy, determined by immunohistochemistry) were analyzed. The prevalence of Gardnerella vaginalis colonization in RM patients was 19.0%, gram-negative anaerobes 20.5%, Candida species 7.9%, group B Streptococcus 11.0% and Enterobacteriaceae 14.8%. Commensal lactobacilli were absent in 14.5% of the women. Chlamydia trachomatis was detected in n=1 case (0.53%). The prevalence of Gardnerella vaginalis and gram-negative anaerobes in RM patients with elevated pNK (>280/μl, n=69) was significantly higher (p=0.012, p=0.04) compared to patients with normal pNK (n=174). In conclusion, RM patients with elevated pNK suffer more often from colonization by Gardnerella vaginalis and gram-negative anaerobes. This might indicate an association between the vaginal microbiota, local inflammation, changes in immune parameters and miscarriage.

High prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in anal and pharyngeal sites among a community-based sample of men who have sex with men and transgender women in Lima, Peru

ObjectivesThis study aimed to characterise the epidemiology of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) and transgender women (TW) in Lima,...

Clinico-anamnestic diagnostics of chronic maxillary sinusitis associated with chlamydial infection

The present study included 201 adult patients presenting with exacerbation of chronic maxillary sinusitis. The presence of Chlamydia trachomatis and Chl. pneumoniae was verified by the direct immunofluorescencetechnique and polymerase chain reaction. The study material consisted of swipes und swabs from the mucous membrane of the middle nasal passage. The information from the patients was collected with the use of a questionnaire specially elaborated for the purpose of this study. The correlation relationships were established by means of gamma-statistics. The method is based on the calculation of the integral index characterizing the risk of development of chlamydial infection using the scoring scale for the evaluation of the clinical and anamnestic characteristics of the patients. The assessment of the risk of chlamydial colonization by the anamnestic method makes it possible to enhance the effectiveness of clinical diagnostics of chlamydial infection and thereby provides a basis for the prescription of the adequate anti-chlamydial treatment facilitating reduction of the frequency of complications and preventing dissemination of the causative factor of the disease. Moreover, this approach creates the conditions for the targeted selection of the patients to be referred to the laboratory verification of Chlamydia. Highoperating performance and effectiveness characteristics of the clinic-anamnestic diagnostics make it a method of choice for the wide application in the clinical practice.

O15.6 Impact of the lng-ius on cervical persistence ofchlamydia trachomatisand vaginal microbiota in a baboon model

Introduction Alterations in vaginal microbiota associated with intrauterine contraception may impact host susceptibility to sexually transmitted infection. We evaluated the effect of the levonorgestrel intrauterine system (LNG-IUS) on cervical persistence of Chlamydia trachomatis (CT) in a baboon model and whether CT persistence was correlated with vaginal microbial community structure. Methods 20 wild caught female olive baboons ( Papio abubis ) were randomly assigned to receive either LNG-IUS and CT inoculation (n = 8), LNG-IUS and sham inoculum (n = 2), CT inoculation alone (n = 8), or sham inoculation (n = 2). Animals were acclimated to the LNG-IUS for 24 weeks after which animals were cervically inoculated once weekly for 5 weeks. Vaginal swabs were collected weekly for microbiome analysis by 16S rRNA-encoding gene sequence analysis. Presence of CT in the cervical epithelium was confirmed with weekly nucleic acid amplification testing (NAAT) and culture. Results Use of the LNG-IUS was significantly associated with positive CT culture (p = 0.04) but not NAAT (p = 0.07). Median time to cervical clearance of CT as detected by NAAT was 12.5 days (range 5–16) for LNG-IUS animals in comparison to 7 days (range 3–10) for non-implanted animals (p = 0.14). Similarly, median time to cervical clearance of CT by culture was 12 days (range 5–15) for LNG-IUS animals and 5 days (range 1–10) for non-implanted animals (p = 0.05). We did not detect significant within group differences between vaginal microbial community structure at baseline and following LNG-IUS insertion, CT inoculation, or LNG-IUS and CT in combination. Conclusions Use of the LNG-IUS was associated with a trend towards cervical persistence of CT in a baboon model. However, this persistence is not explained by alterations in vaginal microbial communities. Disclosure of interest statement The authors have no disclosures to report.

P08.14 Lymphogranuloma venereumin the czech republic

Introduction Lymphogranuloma venereum (LGV) is caused by Chlamydia trachomatis serovars L1 – L3. LGV was considered as tropical disease with typical inguinal syndrome and it wasn’t usual in Europe until 2003, when an outbreak was observed in the Netherlands. This was followed by series of outbreaks emerging in different European countries and North America. A common feature for this epidemic is men who have sex with men (MSM) with signs of severe proctocolitis. Most of the patients are co-infected with HIV and/or other sexually transmitted infections (STI). Methods The National Reference Laboratory for Chlamydia Infections offers a diagnostic service to clinicians. The disease is confirmed by the presence of Chlamydia trachomatis and L1 – L3 serovars from multiplex PCR (Seegene). Multiplex PCR is very useful, because multiple infections are observed in many cases. Results First case of LGV was diagnosed from a lymph node puncture in 2010. Then the number of patients was slowly increasing (5–10 patients per year) and the most cases were diagnosed in 2014 (23 patients). Until March 2015, a total of 56 patients with LGV were confirmed. Characteristics of these cases were similar to those in other European countries. LGV was confirmed among MSM with high prevalence of other STI. Forty-eight patients (85%) were co-infected with HIV. In some cases, HIV and LGV were diagnosed at approximately the same time. Forty-three patients (77%) were co-infected with syphilis. The data on other STI are not completed. The vast majority of patients manifested proctocolitis. Only in few cases the inguinal syndrome was observed. Conclusion Lymphogranuloma venereum is also present among MSM in the Czech Republic. We observed, that the number of cases increases. Certainly, it is necessary to expand testing of chlamydial infection in MSM, because this disease could facilitate HIV transmission. Disclosure of interest statement Nothing to declare.

Abnormal Vaginal pH and Mycoplasma genitalium Infection

Study ObjectiveMycoplasma genitalium (MG) is a sexually transmitted pathogen linked to female morbidity, but testing for MG is not standardized. We aimed to determine which point-of-care (POC) vaginal tests could predict MG infection. Design, Setting, ParticipantsA cross sectional study recruited sexually active adolescent women, aged 14-22 y (n = 217) from an urban medical center. Interventions and Main Outcome MeasuresVaginal swabs were POC tested for pH, amines, clue cells, sialidase, and Trichomonas vaginalis (TV). MG was detected by research-use-only transcription mediated amplification (TMA) assay. Presence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) were confirmed using TMA. Three criteria were required for diagnosis of clinical BV: pH > 4.5, presence of amines, and >20% clue cells. Associations were assessed using logistic regression (LR). ResultsTMA detected MG in 30 (14%), CT in 49 (23%), and NG in 21 (10%) of the samples tested. POC vaginal tests were positive for TV in 21%, amines in 52%, clue cells in 33%, sialidase in 22%, pH > 4.5 in 56%, and clinical BV in 19% of the samples tested. Using LR, pH > 4.5 was a predictor of MG (odds ratio 4.4, P < .05). Of 131 women without clinical BV or TV, 25% of those with pH > 4.5 had MG, compared to 9% of those with pH ≤ 4.5 (P = .02). ConclusionsUntil standardized, approved testing for MG is available, pH may be a useful indicator to suspect MG, especially in the absence of BV and TV.

Detection of Chlamydia Trachomatis by Real-time PCR of a Sample of the Female Population of Maceió, Alagoas, Brazil Referred to the Private and Public Health Services

Introduction: Sexually transmitted infections are relatively frequent and constitute a serious public health problem almost everywhere. Chlamydia trachomatis is the organism responsible for more than half the cases of nongonococcal urethritis, as well as numerous cases of cervicitis. Its behavior is characterized mostly by the absence of symptoms, which is of great concern, especially because of sequelae that this can cause, such as infertility in women. In most developing countries there is no cervicovaginal data on incidence or prevalence of Chlamydia trachomatis. Therefore, they usually work with national estimates from other countries and regions worldwide, provided mainly by the World Health Organization. For lack of more precise information mainly from Brazil and the State of Alagoas, this study aimed to verify the current incidence of Chlamydia trachomatis infection in Maceio, and relate it to clinical, cytological and colposcopic analysis demonstrating the importance of screening and of encouraging this approach in order to improve women’s health. Materials and Methods: The methodology used for the detection of Chlamydia trachomatis was real-time PCR in 514 samples, and sensitivity and specificity were increased, providing meaningful data. Results: The results showed that women between 20 and 35 years showed a frequency of 4.08% for Chlamydia trachomatis. It was also observed that there is no relationship between clinical findings (burning and vaginal discharge) with the obligatory presence of Chlamydia trachomatis, being significant only the results of colposcopy, which in most cases they were altered by PCR analysis-real time was also positive. The number of positive results in samples collected in the public showed superiority when compared to the private sector. Conclusions: The prevalence results lead us to conclude that there is a relationship between socioeconomic status and chlamydia infection, since the women of the city of Maceio trited at public medical services cannot afford in private treatment.

Diagnostic relevance of simultaneous testing for Chlamydia trachomatis and Neisseria gonorrhoeae

The prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infection in a Swiss cohort among individuals consulting for screening or symptomatic reasons is not very well known. Between January 2009 and January 2010, diagnostic samples referred to us to test for either CT or NG or both were simultaneously analysed for both infections. Testing was performed using the commercial m2000sp and m2000rt devices from Abbott Diagnostics involving automated DNA extraction and semi-quantitative real-time polymerase chain reaction (PCR), respectively. A total of 9,245 individuals (8,009 female, 1,236 male) were tested. CT alone was found in 318 (3.97%) samples from female patients and NG infections were found in 5 (0.06%) of the female samples. Six (0.08%) women had both CT and NG infections. The numbers for males were 72 (5.83%) for CT alone, 18 (1.14%) for NG alone and 8 (0.65%) for coincident infections. Among women, a selective testing approach in which only the presence of CT was investigated missed six NG cases (0.07% prevalence, 54.55% of all NG-positive women) and the request to test only for NG missed two CT cases (0.02% prevalence, 0.62% of all CT-positive women). For the male samples, one NG case (0.08% prevalence, 3.85% of all NG-positive men) was missed when only CT was requested and three CT cases (0.24% prevalence, 3.75% of all CT-positive men) were overlooked when only NG testing was requested. A sizeable number (12) of CT and NG cases is missed by physician-referred testing for only one of the two pathogens.